Speech rehabilitation of maxillectomy patients with hollow bulb obturator

Abstract

Aim:To evaluate the effect of hollow bulb obturator prosthesis on articulation and nasalance in maxillectomy patients.Materials and Methods:A total of 10 patients, who were to undergo maxillectomy, falling under Aramany classes I and II, with normal speech and hearing pattern were selected for the study. They were provided with definitive maxillary obturators after complete healing of the defect. The patients were asked to wear the obturator for six weeks and speech analysis was done to measure changes in articulation and nasalance at four different stages of treatment, namely, preoperative, postoperative (after complete healing, that is, 3-4 months after surgery), after 24 hours, and after six weeks of providing the obturators. Articulation was measured objectively for distortion, addition, substitution, and omission by a speech pathologist, and nasalance was measured by Dr. Speech software.Results:The statistical comparison of preoperative and six weeks post rehabilitation levels showed insignificance in articulation and nasalance. Comparison of post surgery complete healing with six weeks after rehabilitation showed significant differences in both nasalance and articulation.Conclusion:Providing an obturator improves the speech closer to presurgical levels of articulation and there is improvement in nasality also.

Speech intelligibility, nasal resonance, and swallowing ability of maxillectomy patients with customized obturator: A non randomized controlled study

“…Prosthetic rehabilitation reduces it to as near to normal levels as possible. [ 10 ] High values of hypernasality were observed with decrease in SI while a significant reduction in hypernasality was noticed with clear speech (i.e., after use of prosthesis). Implying significant correlation between hypernasality and SI[ 12 ] because of which there was difficulty in the understanding speech of patients with high values of hypernasality.…”

“…Kumar et al . [ 10 ] studied articulation and nasalance in patients who after maxillectomy were wearing hollow bulb obturator. They reported articulatory errors, most common being substitution and distortion in dental, dento-alveolar, affricates, and fricatives.…”

“…Different phases of obturator were given from surgical to interim with soft liner and finally definitive obturator. Definitive obturator was fabricated with open bulb design[ 10 ] and followed basic prosthodontics principles of removable dental prosthesis in cobalt-chromium alloy. All clinical steps were done by two Prosthodontists having more than 6 years of experience.…”

Comparison of speech and resonance outcomes across three methods of treatment for maxillary defects

“…4 Kumar and colleagues showed that distortion errors (mainly associated with dental, alveodental, alveolar and labiodental sounds) decreased when patients were provided with an obturator. 6 From a patient perspective, research has shown that understandability of speech and normalcy of resonance with prosthetic obturation relates to quality of life and social interaction. [7][8][9] Thus, research has shown that acceptable speech outcomes can be expected with prosthetic rehabilitation of the maxilla.…”

“…The choice of which treatment to pursue in the future depends on several factors, with one of the most important being expected speech outcomes. Speech outcome measurements, including perceptual evaluation of speech intelligibility, 3,4 aeromechanical evaluation to determine palatopharyngeal orifice area, 3 acoustic evaluation of resonance, 3,5 articulation, 6 and patient perception through standardized questionnaires like the Obturator Functioning Scale, [7][8][9] are important to determine the effectiveness of treatment options for maxillary defects.…”